Active NPI
Central Calif ENT Medical Group
- Plastic Surgery Physician
- Fresno, CA
National Provider Identifier
1083673842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- CENTRAL CALIF ENT MEDICAL GROUP
- Practice address
- 1351 E Spruce Ave
Fresno, CA 93720-3342 - Phone
- (559) 432-3303
- Fax
- (559) 432-1468
- NPI assigned
- Mar 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandi Bartucci
- Title
- Director of Accts. Receivable
- Phone
- (559) 432-3303
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | |||
| Otolaryngology Physician | 207Y00000X | |||
| Plastic Surgery Physician | 208200000X | Primary |
Addresses
Primary practice location
1351 E Spruce Ave
Fresno, CA 93720-3342
Mailing address
1351 E Spruce Ave
Fresno, CA 93720-3342
Phone (559) 432-3303
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ49290Z | Other | CA | BLUE CROSS |
| ZZZ49290Z | Other | CA | BLUE SHIELD |
| GR0070230 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050406001264 | CA | Part B Supplier - Clinic/Group Practice | 6901853316 |
Receives reassigned benefits from 14 practitioners Practice locations: Fresno, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0717022 | Central California ENT Medical Group | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
1351 E Spruce Ave
Ste 100
Fresno, CA 93720
Phone (559) 432-3303
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- Fresno, CA
- NPI 1669431409
CA, Plastic Surgery
-
- Facial Plastic Surgery Physician
- Fresno, CA
- NPI 1518156611
CA, Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1083673842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1351 E SPRUCE AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203342",
"telephone_number": "559-432-3303",
"fax_number": "559-432-1468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 E SPRUCE AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203342",
"telephone_number": "559-432-3303",
"fax_number": "559-432-1468"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL CALIF ENT MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-21",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BARTUCCI",
"authorized_official_first_name": "SANDI",
"authorized_official_title_or_position": "DIRECTOR OF ACCTS. RECEIVABLE",
"authorized_official_telephone_number": "559-432-3303"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "ZZZ49290Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ49290Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0070230",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
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- Central California Asthma Collaborative
- Central California Blood Center
- Central California Faculty Medical Group, Inc.
- Central California Faculty Medical Group, Inc.
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.